Platelet Transfusion Practices in Neonatology: A Single-Center Observational Study

27 Pages Posted: 15 Nov 2021

See all articles by Alexandra Zabeida

Alexandra Zabeida

McGill University - Division of Pediatric Hematology-Oncology

Jacques Lacroix

University of Montreal

Anie Lapointe

University of Montreal

Christian Lachance

University of Montreal

Alexis Cournoyer

University of Montreal

Andréanne Villeneuve

University of Montreal

Abstract

Background: Platelet transfusions are common in the neonatal intensive care unit (NICU), yet practices vary substantially. This study aims to determine platelet transfusion incidence, determinants, and justifications in neonatology.

Design and Methods: Single-centre prospective cohort study, including all patients consecutively admitted to the CHU Sainte-Justine Hospital NICU over a 5-month period in 2013. Data were collected by chart review and transfusion justifications were assessed using a questionnaire.

Results: A total of 401 participants were included. Mean birth weight (BW) was 2.34 ±1.01 kg and gestational age (GA) was 34.4 ±4.5 weeks. Thirty-seven neonates (9.2%) received at least one platelet transfusion. Platelet-transfused neonates were mostly extremely preterm (40,5%) or term (24.3%). The median pre-platelet transfusion count was 57 x 109 /L (9 –285 x 109 /L). Compared to non-transfused patients, those who received at least one platelet transfusion had a significantly lower BW and GA, higher CRIB-II and SNAPPE-II scores (all p<0.001) and were more frequently admitted for respiratory disease (p<0.001), hypoxic-ischemic encephalopathy (p=0.009) and haemolytic disease of the newborn (p<0.001). GA <28 weeks (p<0.001), mechanical ventilation requirements (p=0.008) and platelet nadir ≤150 x 109 /L (p<0.001) upon admission were independently associated with a higher risk of platelet transfusion in this cohort. Most frequent justifications for ordering a first platelet transfusion were low platelet counts (86.5%), underlying disease (78.4%) and illness severity (37.8%).

Discussion: Pre-transfusion platelet counts in neonates varied widely and were higher than the thresholds proposed by available evidence. Several factors other than platelet count predicted risk of platelet transfusion in this cohort.

Note:
Funding Information: This research project was funded by a grant from the Fonds de la Recherche du Québec - Santé (Grant 24460).

Declaration of Interests: The authors have no conflict of interest to declare.

Ethics Approval Statement: The Research Ethics Board of CHU Sainte-Justine Hospital approved this study and waived consent.

Keywords: Platelet, Transfusion, Neonatology

Suggested Citation

Zabeida, Alexandra and Lacroix, Jacques and Lapointe, Anie and Lachance, Christian and Cournoyer, Alexis and Villeneuve, Andréanne, Platelet Transfusion Practices in Neonatology: A Single-Center Observational Study. Available at SSRN: https://ssrn.com/abstract=3963638 or http://dx.doi.org/10.2139/ssrn.3963638

Alexandra Zabeida (Contact Author)

McGill University - Division of Pediatric Hematology-Oncology ( email )

Canada

Jacques Lacroix

University of Montreal ( email )

C.P. 6128 succursale Centre-ville
Montreal, Quebec H3C 3J7
Canada

Anie Lapointe

University of Montreal ( email )

C.P. 6128 succursale Centre-ville
Montreal, Quebec H3C 3J7
Canada

Christian Lachance

University of Montreal ( email )

C.P. 6128 succursale Centre-ville
Montreal, Quebec H3C 3J7
Canada

Alexis Cournoyer

University of Montreal ( email )

C.P. 6128 succursale Centre-ville
Montreal, Quebec H3C 3J7
Canada

Andréanne Villeneuve

University of Montreal ( email )

C.P. 6128 succursale Centre-ville
Montreal, Quebec H3C 3J7
Canada

Do you have a job opening that you would like to promote on SSRN?

Paper statistics

Downloads
44
Abstract Views
283
PlumX Metrics